International Medical Informatics Association (IMIA -

ICANN and Health Domains - Further Request for Urgent Action, Thurs. 16 October

Dear IMIA colleagues and friends -

those of you who attended the IMIA General Assembly meeting in Copenhagen, in August 2013 will recall that we discussed the issue of new Internet health domains, in particular the .health domain. The Board, and especially Prof. Antoine Geissbuhler, as our Liaison Office to the WHO, reported on activity in this area, and the GA supported further activity. We have been engaged in various activities since, but ICANN seems determined to press ahead without the safeguards that many in our community are calling for (including WHO - see

We forward you the following email and call for action, and ask that you support and engage with the requested activities if possible. We additionally ask that you cascade this to colleagues and ask them to also undertake activity. We will report any update to the GA meeting in New Delhi.

Dr. Peter Murray, IMIA CEO (email:
on behalf of the IMIA Board

Hi everyone,
Our saga on the .health is coming to an end, but we have one last and crucial chance to make a difference.  ICANN is having its annual meeting and I’ve been told by friends at WHO and some people very close to the issue that we need some kind of public interest and concern about this or ICANN won’t pay any attention.  That said, there is still the slight chance to make a difference.
I’ve compiled the email below.  Please please send out to your respective networks of friends, students, eHealth folks etc. and ask them to simply follow the instructions and post comments to ICANN online during their public interest session on Thursday.  They can also send to and ask that their comments be included in the public interest session if that is easier but it will be a lot more effective if they are in the public interest session.
Feel free to change the email anyway you like, this is just a template.  Hoping you all can help get the word out, I will personally be attending at least one day of the meeting trying to get our message across to key actors in ICANN.  A contact is trying to set up meetings now…
Hi everyone,
Some of you may know about the research I and colleagues around the world have been pursuing on the new health-related domains published in the Lancet, JMIR, Globalization and Health, and featured by news outlets such as NPR, Kaiser Health News, the CBC, and others.  Right now we have the unique opportunity to make an impact by demanding that that public health interests are a priority in the future of the Internet.
Currently, about a dozen health-related generic top level domains (gTLDs) are being added to the Internet.  They include domains such as .healthcare, .med, .doctor, .clinic and MOST IMPORTANTLY a new .health.  Unfortunately, ICANN is now in the process of awarding this hugely important domain space that could shape the very future of health information online to a company that has no interest nor expertise in public health.  Basically, ICANN has ignored key stakeholders including the World Health Organization, World Medical Association, Save the Children, IMIA, France, Mali, and others who have expressed great concern about ICANN’s treatment of the  This recently ended in a secret and private settlement to award the .health that was scheduled to go to a public bidding process.
This decision is important as it will impact global public health and the health of individual consumers.  As people increasingly use the Internet for health information and use that information to make crucial treatment decisions, the quality and trustworthiness of health information online has never been more important.  A .health that was properly governed, had sufficient participation from the medical and public health community, and that was structured as a global public good for the broader community, could have been a game changer for ensuing the reliability of health information online and improving health outcomes.   This has not happened, as ICANN has focused on economic and commercial interests over public health.
What you can do
We are now engaged in a last ditch push to make a real difference here and we have an opportunity to do so.  Right now ICANN is having their annual meeting in Los Angeles. After discussions with friends at WHO, other academics, and even those sympathetic to our cause within ICANN, we’ve learned that only the broader public health and medical community can make a difference.  For this reason, I am hoping you will join our coalition in letting ICANN know that the concerns of the public health community for the .health need to be addressed immediately.  
You can make a difference by directly engaging in ICANN’s policy processes via an online public forum this THURSDAY, OCTOBER 16 - 14:00-17:00PM PDT.  Participation is easy and will not take much of your time:
All you have to do is visit the following URL (, and then click the “Virtual Meeting Room Stream Live” link, click the option to participate as a guest, and you will be entered into an adobe connect chat room where you can participate and voice your concerns.  Some of the concerns that could be addressed are: 
-why has ICANN ignored calls by the WHO, World Medical Association, France, Mali, and others about the
-why did ICANN award the .health with no transparency through a secret settlement?
-why has ICANN not responded to multiple letters sent to their board about the .health asking for a moratorium/suspension of the process? 
-why does ICANN treat other domains such as .wtf, .sucks, with better safeguards than the .health?
-why has ICANN not listened to the public health community about the .health and other health-related domains?
-health is such an important issue, shouldn’t we have a place on the Internet where we can trust our health information?
I will be personally attending the ICANN meeting in LA and meeting with certain key ICANN officials to try to make an impact.  Please join us so that we can ensure the .health is a place to improve your health, not harm it.
If you have any questions feel free to contact me at anytime at  Only with your help can we hope to make a difference.
References and Sources
Published articles:
·        Mackey TK, Liang BA, Kohler J, Attaran A. The Fight over dot-health: Ensuring the Future of Health Information Online. The Lancet. 2013; 382:1404.
·        Mackey TK, Liang BA, Kohler JC, Attaran A. Health Domains for Sale: The Need for Global Health Internet GovernanceJ Med Internet Res. 2014;16(3):e62. 
·        Mackey TK, Eysenbach G, Liang BA, Kohler JC, Geissbuhler A, Attaran A. A Call for a Moratorium on the .health Generic Top-Level Domain: Preventing the Commercialization and Exclusive Control of Online Health InformationGlobal Health: 2014; 10:62. 
News articles:
Tim K. Mackey, MAS, PhD
Director, Global Health Policy Institute (
Associate Director, Joint Masters Program in Health Policy and Law
Assistant Professor
UC San Diego, School of Medicine
Twitter: @tkmackey


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